From the FDA Drug Label
CLINICAL PHARMACOLOGY While the precise mode of action of dimenhydrinate is not known, it has a depressant action on hyperstimulated labyrinthine function. The treatment for labyrinthitis may involve the use of dimenhydrinate (PO), which has a depressant action on hyperstimulated labyrinthine function, however, the precise mode of action is not known 1.
- Dimenhydrinate can be used to treat symptoms related to labyrinthitis. The use of dimenhydrinate should be done with caution and under medical supervision.
From the Research
Treatment for labyrinthitis should prioritize corticosteroids, such as prednisone, to reduce inflammation and suppress abnormal nerve signals, as evidenced by the most recent and highest quality study 2. The goal of treatment is to manage symptoms, reduce inflammation, and allow the brain to compensate for the disrupted balance system.
- For mild cases, over-the-counter antihistamines like dimenhydrinate (Dramamine) or meclizine (Bonine) at 25-50mg every 4-6 hours can help reduce vertigo and dizziness.
- For more severe symptoms, a doctor may prescribe vestibular suppressants like diazepam (Valium) at 2-5mg three times daily for short-term use, or antiemetics such as promethazine (Phenergan) 12.5-25mg every 4-6 hours to control nausea and vomiting.
- Corticosteroids like prednisone (starting at 60mg daily with a tapering schedule over 10-14 days) may be prescribed if inflammation is significant, as supported by studies 2, 3. During recovery, patients should:
- Rest in a quiet, darkened room during severe episodes
- Avoid sudden head movements
- Gradually increase activity as symptoms improve
- Stay hydrated Most cases of viral labyrinthitis resolve within 1-3 weeks, though some symptoms may persist longer, and treatment works by reducing inflammation in the inner ear, suppressing abnormal nerve signals that cause dizziness, and allowing the brain to compensate for the disrupted balance system, as noted in 4, 5.